Prostate Cancer Should Have Same Awareness As Breast Cancer

Anyone who reads a newspaper, watches television, goes online or is a football fan knows October was breast cancer awareness month. The iconic pink that has come to symbolize the disease — from dyed women's tresses, to the stylish ties donned by news anchors, to the mouthpieces used by NFL behemoths —- were everywhere.

Pink has managed to crowd out autumn's dazzling hues.

What is missing from this palette is blue. Blue as in blue that some might recognize as standing for prostate cancer awareness. September, as virtually no one is aware, was Prostate Cancer Awareness month. The lack of recognition must change.

Advocacy groups such as the Susan G. Komen foundation have done a marvelous job promoting education and action to combat breast cancer and increase survival rates. They are to be commended.

The public education surrounding prostate cancer must advance commensurately — and right now.

Some men's health advocacy groups continue to argue that prostate cancer is not a deadly disease and that those found to have it will more than likely die with it, but not from it. This is a problem.

The incidence rate of prostate cancer in men is nearly exactly equal to that of breast cancer in women, about one in six. Yet last year we spent $631 million on breast cancer research and $300 million on prostate cancer, according to the most recent statistics from the National Cancer Institute.

Complicating matters is the recent debate in the field of medicine over how the public should view prostate health. These same groups are now advocating that a highly accurate, simple and beneficial procedure known as the prostate specific antigen, or PSA test, should not be administered. The groups believe that this test may lead to other more invasive and perhaps needless procedures that will do more harm than good.

The potential downsides usually cited are changes in urinary control and erectile dysfunction.

There is significant data to support continued PSA testing. Since the advent of the PSA, the death rate for those diagnosed with prostate cancer has dropped 20 percent. The incidence of prostate cancer spreading to other regions of the body has dropped by 75 percent. Why would you not want to have this test as a valuable diagnostic tool that I am convinced has saved and extended many lives?

The PSA test is merely a flag that something may not be right with a man's prostate gland. An elevated reading can lead to further tests such as a biopsy. About 30 percent of these biopsies revealed cancer. By comparison, about 17 percent of breast cancer biopsies prove positive.

If the prostate biopsy is positive, there are more treatment options: observation or "active surveillance,'' radiation in the form of radioactive seeds and radical prostatectomy, usually performed robotically.

Detection and treatment of prostate cancer is based on a variety of factors. One is age. Current guidelines suggest men between 55 and 70 should be tested annually. The numbers are based on the lower incidence of cancer before age 55 and the expected life span after 70.

African American men should be tested earlier than 55 because they have a higher incidence rate for the disease. The same should be said for anyone with a family history of prostate cancer.

Critics of the test often claim that doctors would have to screen 1,000 men to save one life. But it is the quality of life that is so important post-screening. Left undetected, prostate cancer advances and can cause great pain and suffering. I saw it too often in my practice.

It is not a just harmless disease that you will die with, but can be a painful way to die.

We need to create a greater awareness of these issues and we need more resources put into research. Getting a PSA test is a critical component in this endeavor.

My hope is that one day soon blue will be as conspicuous as pink — heightening awareness about this most critical men's health issue.

Jeffrey V. Rabuffo of the Higganum section of Haddam is a retired urologist.